Apparatus for performing hippotherapy

ABSTRACT

A therapeutic riding device which treats physical and mental impairments of riders by simulating the motion of a horse in three dimensions. A patient sits on a seat ( 12 ) which is mechanically driven by a motor ( 13 ) and an arrangement of members having cams ( 33   a,    33   b ). The three-dimensional pattern made by the seat may be controlled so as to mimic an ideal hippotherapy horse.

This application claims the benefit of provisional application No.60/077,580 filed Mar. 10, 1998.

TECHNICAL FIELD

The present invention relates to riding devices, and more particularlyto a therapeutic riding device which treats physical and mentalimpairments of riders by simulating the motion of a horse in threedimensions.

BACKGROUND OF THE INVENTION

Hippotherapy is the use of horseback riding to enhance the balance andmuscle function of people with neurological disorders. This techniqueoriginated in Germany and has been used in the United States since the1950's. In the United States licensed physical and occupationaltherapists have designed hippotherapy treatments for over 26,000neurologically impaired riders.

Physical therapists have documented the following medical benefits ofhippotherapy: decreased spasticity, improved balance, improvedcoordination, improved gait, improved posture, and improved range ofmotion. Occupational therapists have reported that hippotherapy improvesthe organization of the sensory system, increases oral motor control,improves cognition, awareness, and processing, improves hand control,and increases the psycho-social interaction of the rider with theenvironment.

Unfortunately the cost of boarding, feeding, training, grooming, andcaring for a horse for use in hippotherapy has prevented many therapistsfrom utilizing this therapeutic exercise. In fact, due to the lack of acost-effective hippotherapy treatment method, in conjunction withdwindling insurance reimbursements, many therapy centers simply can notafford to implement a hippotherapy program.

The use of a horse in hippotherapy has several inherent limitations. Forexample, it is difficult to select and train a horse for hippotherapy.Only about 15% of the available horses in the United States fit thecriteria for the proper pelvic, trunk, hip, and leg movements duringwalking to be of therapeutic value to the rider. If a suitable horse canbe found, it must then be trained to accommodate a physically orneurologically impaired rider. This includes desensitization of thehorse to the sights and sounds associated with moving wheelchaircomponents, unusual vocalizations or limb movements from the rider,stiff legs and trunk of the rider, an inability of the neurologicallyimpaired rider to shift his/her weight when necessary, and the manyvolunteers walking beside the horse and possibly holding the rider. Oncea horse is selected, most often that horse is kept in a horse arenawhich may be out-of-town. Having to travel to perform hippotherapy isinconvenient for the caregiver or parent of a neurologically impairedrider. If more than one horse is used for hippotherapy, the anatomicaland biomechanical variations between the horses may prevent riders fromexperiencing the same level of therapy from one treatment session toanother.

Often, hippotherapy is limited by weather conditions and the mood of thehorse. Rain, lightning, or high winds can startle a horse, requiringimmediate dismount of the rider and cessation of the hippotherapytreatment. Also, horses may become agitated from seemingly insignificantincidents such as a piece of paper blowing across the dirt, other horseswalking into the arena, sudden movements, or loud noises. In order toprevent a horse from bolting out of an arena with the mounted rider orrearing up onto its hind legs throwing the rider off the saddle, aperson leading the horse often needs to tightly control the reins whilestanding in front of the horse.

Other problems associated with hippotherapy arise due to the conditionof the rider. Neurologically-impaired riders often require three to fourpeople at the horse arena to (a) determine the most therapeutic positionfor the rider receiving hippotherapy, (b) groom and saddle the horse,(c) assist in the transfer to and from the horse, and (d) lead or walkbeside the horse. In the event that one or more of these people areabsent, the rider often can not safely receive hippotherapy, sotreatment must be canceled. Physically or psychologically impairedriders sometimes have weak or no strength in their hands which preventsthe riders from forming a good grip onto the horn of a horse's saddle.Furthermore, riders often have poor balance and coordination.Additionally, it is often difficult for riders to regain control of astartled horse, even if assisted by a therapist. Because someneurologically impaired riders require additional physical supportduring hippotherapy, an adult often sits on the same horse and holds thepatient from behind. This technique, however, puts extra strain on theback of the horse which can cause it injury. If a horse's back has beeninjured, no riding will be allowed until the injury has healed.

Finally, hippotherapy carries with it the risk of injury to the rider orto therapists assisting the rider. Therapists may be stepped on orkicked by the horse. Riders may fall off a startled horse, incurringserious injury despite the use of a helmet.

The problems enumerated in the foregoing are not intended to beexhaustive but rather are among many which tend to impair theeffectiveness of previously known hippotherapy treatments. Othernoteworthy problems may also exist: however, those presented aboveshould be sufficient to demonstrate that hippotherapy treatment in theart has not been altogether satisfactory.

SUMMARY OF THE INVENTION

Biomechanical analyses of the three planes of movement which occur ashorses walk have provided much information on pelvic movements of anideal hippotherapy horse. It has been determined that an idealhippotherapy horse has a walking pace of 60-120 steps per minute. Such apace is believed to provide for maximum therapeutic value for a riderpatient. Analyses of the effects imposed on the rider currently indicatethat three dimensional cyclic movement patterns of the horse's pelvisshould be within the following parameters: a lateral pelvic tilt ofabout 5° to about 15°, with a preferred lateral pelvic tilt of about10°. This value was determined by drawing an imaginary line in they-direction through the posterior aspect of the ileum bone comprisinghalf of the pelvis. As the horse completed push-off and began the swingphase of the hind limb forward, that half of the pelvis tilted out(laterally). A second imaginary line was drawn through the same pointson the posterior aspect of the ileum. The angle between these two linesduring rotation of the ileum along the z-axis was determined to be about5° to about 15° and was called the lateral pelvic tilt.

During limb acceleration (swing phase) the horse's trunk and pelvis wererotated forward about 3° to about 15°, with an average rotation of about5° to about 8° (with the spine as the origin of the angle). Similarly,deceleration of the limb in the stance phase caused rotation of thatside of the pelvis in the opposite direction. Schematic representationof this motion can be described as a rotation about the local z-axis atthe left pelvis (point B of FIG. 1) of the horse. A clockwise rotationabout the z-axis, viewed from above the horse, would result in a pelvicrotation forward. The same clockwise rotation along the local z-axis atthe right pelvis (point A of FIG. 1) would result in a pelvic rotationback toward the tail of the horse.

Coupled with the pelvic rotation is a lateral displacement along thex-axis of about 3 cm to about 12 cm. Ideally, 7-8 cm of lateral pelvicdisplacement would occur. Note that lateral pelvic displacement occursin the positive x-direction on the left side and in the negativex-direction on the right side of the body. The lateral pelvicdisplacement was measured at the greatest point of the arc along thelocal x-axis and was directly related to the size of the pelvis of thehorse.

A displacement occurs along the z-axis as the horse loads and thenunloads the hind limb. This measurement was recorded by measuring thechange in the height of the pelvis from the neutral line between point Aand point B (FIG. 1) and (FIG. 16). Depending on the height of thehorse, this displacement on the average horse was found to be about 2 cmto about 10 cm, with a preferred value of about 5 cm.

In addition, the horseback rider experiences a cyclic rise and fall ofone side of the saddle as the horse's pelvis tilts up and down in the xyplane. During the swing phase of the right hind limb, the right side ofthe pelvis undergoes a posterior pelvic tilt (tilts up to allowclearance of the limb). After hoof strike, the limb is decelerating andis aided by an anterior tilt of the horse's pelvis on that side. Thiscauses the iliac crest to drop downward toward the ground, weighting thelimb for greater deceleration. This movement corresponds to a rotationalong the local x-axis (FIG. 1 and FIG. 7). Looking toward the x-axis ofrotation (left to right), a counterclockwise rotation of the localx-axis corresponds to an anterior tilt of the horse's pelvis with alowering of the rider (FIG. 1 and FIG. 2). The anterior tilt occurs in arange of about 2° to about 15°, with a preferred anterior tilt of about3° to about 10°. Similarly a posterior tilt corresponds to a clockwiserotation along the local x-axis and could occur in the range of about 2°to about 25°, with a preferred posterior tilt of about 3° to about 7°(FIG. 7).

A therapeutic riding apparatus for simulating three dimensional motionof a horse, in accord with the invention, comprises a split seat withtwo independent axes of rotation and a plurality of members mechanicallycoupled to the split seat. The seat is covered with a thick cushionedsurface capable of transmitting the three dimensional movementsgenerated from two local axes. The plurality of members drive the splitseat in a three dimensional pattern which mimics the three dimensionalmotion of the torso of the horse upon which the rider is seated.

In accord with one aspect of the invention, the three dimensionalpattern includes simulating the number of horse steps per minute, withabout 20 to about 200 horse steps per minute being preferred, and about60 to about 120 simulated horse steps per minute being more preferred.Further, the three dimensional pattern simulates the horse's cycliclateral pelvic tilt of approximately ten degrees. Even further, thethree dimensional pattern simulates the horse's cyclic pelvic rotationof about five degrees to about eight degrees with a correspondinglateral pelvic displacement along the x-axis of about seven to eightcentimeters. In addition, the three dimensional pattern on each sidesimulates an upward displacement along the z-axis of about 5 centimetersfrom the neutral line and a downward displacement along the z-axis toabout 5 centimeters below the neutral line for a total excursion ofabout 10 centimeters. Yet further, the three dimensional patternsimulates the cyclic anterior or posterior tilt of three to ten degrees.

An apparatus for performing hippotherapy, in accord with another aspectof the invention, includes a cushioned split seat configured to supportone or two adult riders. Two outer cams are coupled to the seat and areconfigured to propel the seat in a first set of directions. Two innercams are coupled to the seat and are configured to propel the seat in asecond set of directions. Two innermost cams are coupled to a linkagesystem to propel the seat in a third set of directions.

In accord with yet another aspect of the invention, the cam pairs aremachined to simulate movement in each of three dimensions. The cams ineach pair are positioned 180° to each other in order to create analternating movement pattern of the left and right sides of the splitseat corresponding to an alternating pattern of a horse's gait.

In accord with another aspect of the invention, the cam pairs may besubstituted for other cam pairs having different eccentricities or othersuch attributes to change a movement pattern of the seat.

In accord with another aspect of the invention, the degree of movementof each cam pair is not dependent on the other two cam pairs, such thata cam pair could be substituted to provide little to no movement in onedimension without altering the remaining two dimensions of movement.

A riding device, in accord with an alternate embodiment of theinvention, includes a cushioned split seat adapted to support one or twoadults. Two or more members are configured to drive each half of theseat in two separate three dimensional cyclic patterns that mimic thetwo movement patterns of the left and right side of a horse in motion.

A hippotherapy device, in accord with another embodiment of theinvention, may include a cushioned split seat. An outer member ismechanically coupled to the split seat and is adapted to move one sideof the seat forwards and backwards (rotation about the local z-axis).This member is designed in such a way that there is a correspondingopposite and equal movement on the other side. This results in an arc ofmotion consisting of a lateral pelvic displacement (along the localx-axis). An inner cam set rotates along the local x-axis, but due to itsdesign results in an upward or downward movement of the seat(displacement along the local z-axis). An innermost cam set, whenrotated along the local x-axis is kept in contact with the cam followerthrough tension provided by a spring. The preferred embodiment is aclosed track cam system, in which no spring is needed. As the camfollower moves, the angle of a linkage mechanism is increased ordecreased, affecting the angle of the seat. When the seat is tippeddownward, it corresponds to the anterior tilt of the horse's pelvis.Similarly, when the seat is tipped upward, it simulates the posteriortilt of the horse's pelvis during gait. The left and the right cams foreach cam pair are custom machined and positioned at 180° to each other.In addition, the corresponding member is positioned such that therotation along each local axes will be equal and opposite correspondingwith the movements of the left and right sides of a walking horse. Adriving shaft is rotated by a rotational force and is coupled to theouter. inner, and innermost cam pairs and is configured to drive theouter, inner, and innermost members. In a typical embodiment, a motorprovides the rotational force.

An apparatus for treating physical and mental impairments of a patientby simulating the motion of a horse, in accord with the invention, mayinclude a cushioned split seat for supporting the patient and ifnecessary, the therapist. A pair of outer cams is coupled to the seat. Apair of inner cams is coupled to the seat. A pair of innermost cams iscoupled to the seat. A motor is coupled to the pair of outer cams and tothe pair of inner cams and to the pair of innermost cams. As usedherein, the term “motor” refers to an electric, hydraulic, or any otherrotational force generator. In preferred embodiments, the motor is anelectrical motor. Some advantages of an electric motor include itslightness in weight relative to other motors, relative low cost,potential to utilize batteries in portable situations, and ease of use.Other types of motors may, however, be suitable for manipulating thepresent invention. For example, it is envisioned that a hydraulic powerunit (which may be controlled by an electric motor) driving a hydraulicpump may offer certain advantages in control and manipulation of thespeed of the cycles. Similarly, a hydraulic pump could provide power fordouble acting hydraulic cylinders. Similarly, a pneumatic pump poweringa pneumatic motor may also be used to power the present apparatus,depending on a particular application. It is also recognized that thepresent invention may be controlled by microprocessors, which may offeradvantages in manipulating the three dimensional mover, heating pad, orany other elements or added features of the invention. Furthermore, itis envisioned that the movements described in the present disclosurecould be controlled by a linear or rotary servo mechanism consisting ofa computer numerically controlled unit or other forms of microprocessorswith electromechanical actuators, encoders, and tachometers and still bewithin the scope and spirit of this invention. Advantages to the servomechanism include the ability to progress the patient to a morechallenging degree of motion without exchanging the cams. The servomechanism would provide an infinite level of control over the degree ofmotions.

These and other objects, features, and advantages of the invention willbe further described and more readily apparent from a review of thedetailed description of typical embodiments which follows.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1, is a schematic representation of the local axes of rotationabout points A, B, C or D corresponding to the horse's pelvis and therelative position of the rider.

FIG. 2 illustrates the coordinate system for the horse and threedimensional mover in accordance with the present disclosure.

FIG. 3 is a side view of a three dimensional mover from the left inaccordance with the present disclosure. The platform 1 for tiltmechanism 22 is not drawn to scale. The size and shape of the cams areschematically drawn.

FIG. 4 is a rear view of a three dimensional mover in accordance withthe present disclosure. The platform 1 for tilt mechanism 22 is notdrawn to scale. The size and shape of the cams are schematically drawn.

FIG. 5 is a top view of a three dimensional mover in accordance with thepresent disclosure. The size and shape of the cams are schematicallydrawn.

FIG. 6 shows a hand held device for use with a three dimensional mover.

FIGS. 7-15 illustrate rotations about the local x-axis at points A and B(with reference to FIG. 1). The data set forth in FIGS. 8-15 is recordedin terms of rotations about local x-axes at points A and B (clockwise(CW) rotation pertains to posterior tilt of the horse pelvis at A or B;counter clockwise (CCW) rotation pertains to anterior tilt).

FIG. 7 illustrates Z-Displacements of points C and D.

FIG. 8 illustrates the terminal stance position of a horse: C:RotationX, clockwise (CW) 2° from position of FIG. 15, (4° below neutral); D:Rotation X, counter clockwise (CCW) 10° from position FIG. 15, (3° belowneutral).

FIG. 9 illustrates the push-off position of a horse: C:Rotation X,counter clockwise (CCW) 6° from position of FIG. 8, (10° below neutral);D: Rotation X, clockwise (CW) 2° from position of FIG. 8, (1° belowneutral).

FIG. 10 illustrates mid-swing position of a horse: C:Rotation X,clockwise (CW) 14° from position of FIG. 9, (4° above neutral); D:Rotation X, counter clockwise (CCW) 1° from position of FIG. 9, (2°below neutral).

FIG. 11 illustrates terminal swing position of a horse: C:Rotation X,clockwise (CW) 3° from position of FIG. 10, (7° above neutral); D:Rotation X, counter clockwise (CCW) 4° from position of FIG. 10, (6°below neutral).

FIG. 12 illustrates hoof strike position of a horse: C:Rotation X,counter clockwise (CCW) 10° from position of FIG. 11, (3° belowneutral); D: Rotation X, clockwise (CW) 2° from position of FIG. 11, (4°below neutral).

FIG. 13 illustrates initial stance position of a horse: C:Rotation X,clockwise (CW) 2° from position of FIG. 12, (1° below neutral); D:Rotation X, counter clockwise (CCW) 6° from position of FIG. 12, (10°below neutral).

FIG. 14 illustrates mid stance position of a horse: C:Rotation X,counter clockwise (CCW) 1° from position of FIG. 13, (2° below neutral);D: Rotation X, clockwise (CW) 14° from position FIG. 13, (4° aboveneutral).

FIG. 15 illustrates late stance position of a horse: C:Rotation X,counter clockwise (CCW) 4° from position of FIG. 14, (6° below neutral);D: Rotation X, clockwise (CW) 3° from position of FIG. 14, (7° aboveneutral).

FIGS. 16-24 illustrate rotations about the local x-axis at points A andB (with reference to FIG. 1). Rotation of cams 32 a and 32 b is aboutlocal x-axis. The data set forth in FIGS. 16-24 is recorded in terms ofz-displacements at points A and B.

FIG. 16 illustrates Z-Displacements of Points A & B. The distancebetween points A and B is equal to 45 cm minimum, 70 cm maximum.

FIG. 17 illustrates the terminal stance position of a horse: A: −6 cmfrom position of FIG. 24 (5 cm below neutral; B: −2 cm from position ofFIG. 24 (5 cm below neutral).

FIG. 18 illustrates the push-off position of a horse: A: 2 cm fromposition of FIG. 17 (3 cm below neutral; B: 4 cm from position of FIG.17 (1 cm below neutral).

FIG. 19 illustrates the mid swing position of a horse: A: 8 cm fromposition of FIG. 18 (5 cm above neutral; B: 4 cm from position of FIG.18 (3 cm above neutral).

FIG. 20 illustrates terminal swing position of a horse: A: −8 cm fromposition of FIG. 19 (3 cm below neutral; B: −2 cm from position of FIG.19 (1 cm above neutral).

FIG. 21 illustrates the hoof strike position of a horse: A: −2 cm fromposition of FIG. 20 (5 cm below neutral; B: −6 cm from position of FIG.20 (5 cm below neutral).

FIG. 22 illustrates the initial stance position of a horse: A: 4 cm fromposition of FIG. 21 (1 cm below neutral; B: 2 cm from position of FIG.21 (3 cm below neutral).

FIG. 23 illustrates the mid stance position of a horse: A: 4 cm fromposition of FIG. 22 (3 cm above neutral; B: 8 cm from position of FIG.22 (5 cm above neutral).

FIG. 24 illustrates the late stance position of a horse: A: −2 cm fromposition of FIG. 23 (1 cm above neutral; B: −8 cm from position of FIG.23 (3 cm below neutral).

FIGS. 25-32 illustrate rotations about the local z-axis at points A andB (with reference to FIG. 1). The data set forth in FIGS. 25-32 isrecorded in terms of rotations about local z-axes at points A and B

FIG. 25 illustrates the terminal stance of a horse: A: 2° rotation, CW(8° from neutral); B: 2° rotation, CW (8° from neutral).

FIG. 26 illustrates the push-off position of a horse: A: No change; B:2° rotation, CCW (6° from neutral).

FIG. 27 illustrates the mid-swing position of a horse: A: 7° rotation,CCW (1° from neutral); B: 8° rotation, CCW (2° from neutral).

FIG. 28 illustrates the terminal swing position of a horse: A: 7°rotation, CCW (6° from neutral); B: 4° rotation, CCW (6° from neutral).

FIG. 29 illustrates the hoof strike position of a horse: A: 2° rotation,CCW (8° from neutral); B: 2° rotation, CCW (8° from neutral).

FIG. 30 illustrates the initial stance position of a horse: A: 2°rotation, CW (6° from neutral); B: No change (8° from neutral)

FIG. 31 illustrates the mid stance position of a horse: A: 8° rotation,CW (2° from neutral); B: 7° rotation, CW (1° from neutral).

FIG. 32 illustrates the late stance position of a horse: A: 4° rotation,CW (6° from neutral); B: 7° rotation, CW (6° from neutral).

FIG. 33 illustrates the application of the three dimensional mover inaccord with the present invention with a tall and heavy adultaccompanied by an adult therapist. This application could not beachieved on a horse according to the North American Riding for theHandicapped Association safety guidelines. See FIG. 3 and FIG. 4 for theshape of an exemplary embodiment of the present invention.

FIG. 34A, FIG. 34B and FIG. 34C illustrate the application of the threedimensional mover in accord with the present invention to strengthen thetrunk and pelvic muscles of a patient.

FIG. 35A, FIG. 35B, FIG. 35C, FIG. 35D, FIG. 35E, and FIG. 35Fillustrate the application of the three dimensional mover in accord withthe present invention in dynamic activities: FIG. 35A shows upper trunkand upper extremity strengthening, FIG. 35B shows alternating leg swingin sitting, FIG. 35C shows trunk rotation with upper extremities movingin functional diagonal patterns. FIG. 35D shows back, hip, and shouldermuscle strengthening, FIG. 35E shows continuous passive threedimensional motion at the wrist and shoulder in a weight bearingposition, FIG. 35F shows vaulting exercises to progress to standing onthe dynamic surface.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

In the drawings, depicted elements are not necessarily drawn to scaleand like or similar elements may be designed by the same referencenumeral throughout the several views. The actual contour and surface ofthe cams are only schematically illustrated.

FIG. 1 illustrates the direction of the y-axis from the head to the tailof the horse as well as the direction of the x-axis from the right tothe left side of the horse. The same orientation is used to describe thethree dimensional mover of the present invention. In a typicalembodiment, the dimensions for the seat 12 (which, in an exemplaryembodiment may be a split seat) upon which the rider sits is illustratedschematically as about 80 cm in length with a minimum width of about 30cm and a maximum width of about 70 cm. The dotted box around points B/Dand A/C depict the independent motions of the left and right side of thedevice and not the split seat. Also shown is the location of the localx-axis of rotation located about 70 cm from the center line of the riderat point A or B. Implied is the location of the local y-axis of rotationlocated about 24.5 cm to about 35 cm from the center line of the riderat point A or B. It is recognized that these dimensions are approximate,and are for illustrative purposes to show various aspects of theinvention. It is recognized that other dimensions may be used and stillbe within the scope and spirit of the invention.

FIG. 2 shows all three axes of the coordinate system. The direction ofthe z-axis passes vertically from the belly of the horse to the back orriding surface of the horse. The same direction and orientation of theaxes will be used when describing the three dimensional mover.

FIG. 3 illustrates a side view of a most typical embodiment 100. In thisside view, reference numerals are shown with a “b” to indicate that theelement is a left side element. However, the specification refersgenerally to elements without reference to “a” or “b.” As shown in FIG.3, the seat 12 (as shown in FIG. 3, seat 12 is a split seat havingportions 12 a (not shown in FIG. 3) and 12 b) of the three dimensionalmover 100 is located about 96.5 cm to about 115 cm from the ground andmay support a weight of approximately 350 pounds (159 kg). It isrecognized that these dimensions are approximate, and are forillustrative purposes to show various aspects of the invention. It isrecognized that other dimensions may be used and still be within thescope and spirit of the invention.

An impaired rider sits on surface 70 (schematically illustrated in FIG.33, FIG. 34a, FIG. 35b, and FIG. 35c), which is adapted on seat 12. Seat12 may be constructed from sheet-metal, wood, plastic, or any othersuitable material or combination thereof Seat 12 is designed so that thesurface is split along the y-axis to allow independent three dimensionalmovement of the left versus the right sides. Seat 12 is designed so thatdifferent width platforms and cushioned surfaces 70 can be added.Alternatively, different types of saddles may be used to increase thewidth of the riding surface. In a most typical embodiment, theexchangeable platforms come in a selection range with about 1.91 cm (¾inch) increments. In other embodiments, the range of exchangeableplatforms for use over seat 12 may be in increments of about 0.64 cm (¼inch), about 1.27 cm (½ inch), or about 2.54 cm (one inch) or other morecommonly used metric increments. Each exchangeable platform can becovered with a surface 70. The exchangeable platform widths for use overseat 12 allow riders of different sizes, or those with limited range ofhip motion, or restricted hip/pelvic muscle length to sit comfortablyupon three dimensional mover 100. In a most typical embodiment, seat 12is long enough to accommodate two adults (schematically illustrated inFIG. 33). It is often important for a therapist to ride behind a clientand to assist directly with balance exercises. With the use of a horse,this practice is limited to small children due to the weightrestrictions of the horse's back. In addition, it is difficult andunsafe for an adult to “backride” a client whose head is above the levelof the therapist's chin, impairing the visual field of the therapist.

In a most typical embodiment, surface 70 will have a heated surface.Heating may be accomplished by incorporating a suitable heating element(not shown) in, on, or near surface 70. The warmth of surface 70 createsa feeling of bareback riding by simulating the physiological temperatureof a horse. It has been suggested that such warmth may improve theabnormal muscle tone of the rider, leading to increased coordination,range of motion, function, and balance. The outer surface of seat 12 maybe cushioned with any flexible material comprising surface 70,including, but not limited to foam, pockets of gel, pockets of air,pockets of fluid and then covered with any number of different types ofmaterials, including, but not limited to, leather, vinyl, plastic, orcloth.

FIG. 3 also shows a tilt mechanism 22. Tilt mechanism 22 inclines theentire three dimensional mover to simulate the therapeutic ridingtechnique of a horse walking up or down a hill. In a most typicalembodiment, tilt mechanism 22 is constructed of an AC linear actuator, a115 Volt AC limit switch with automatic brake-set ball brake, a 12 VoltDC motor, an overtravel protector, a load limiting friction disc clutch,and an automatic spring brake. An inclinometer is associated with tiltmechanism 22, inclinometer 23 measuring the tilt of three dimensionalmover 100. In a most typical embodiment, inclinometer 23 is an ACCUSTAR™electronic inclinometer that interfaces with a digital readout locatedon three dimensional mover 100. In that most typical embodiment,inclinometer 23 has a resolution of about 0.001° and a range of ±about60°. In certain embodiments, inclinometer 23 may have a digital readoutlocated on a hand held control device, such as the hand held device 21of FIG. 6.

Also illustrated in FIG. 3 is a safety switch 24. When depressed, safetyswitch 24 shuts off power to the three dimensional mover, stopping itsoperation almost instantly. Such a switch provides therapists with aneffective, quick means for removing impaired patients from the ridingdevice in the case of an emergency or any other situation in which themachine needs to be turned off quickly. In a most typical embodiment, anadditional safety switch 25 is located on a hand held device, such ashand held device 21 of FIG. 6. The convenient location of safety switch25 allows a caregiver, even if she cannot reach safety switch 24, toquickly shut off the power to three dimensional mover 100.

Further illustrated in FIG. 3 is platform 1 that supports tilt mechanism22. Platform 1 (not to scale) may be constructed of any suitablematerial capable of supporting the therapeutic riding device. In a mosttypical embodiment, wheels 27 are attached to the underside of platform1. Wheels 27 may be caster wheels or any other suitable type of wheels.Wheels 27 may have individual locks that may be engaged when thetherapeutic riding device is in operation. Such locks control or preventunwanted sliding of the platform 1 supporting the three dimensionalmover when the apparatus is in operation. When wheels 27 are not locked,caregivers can move the three dimensional mover to a convenientlocation. Additionally, wheels 27 allow a caregiver to roll thetherapeutic riding device while it is in operation. For example, acaregiver might choose to roll the three dimensional mover in a FIG. 8pattern while in operation to further challenge the balance of a rider.Attached to platform 1 is speed control mechanism 20. Speed controlmechanism 20 is in operative relation to a power source of the threedimensional mover and controls the speed of operation of the therapeuticriding device. In a most typical embodiment, a varistat for controllingthe simulated number of steps per minute of the three dimensional moveris located on a hand held control device, such as hand held device 21 ofFIG. 6.

FIG. 3 also illustrates main support frame 2. Main support frame 2supports shaft 3, which supports linear bearings 8. In a most typicalembodiment, main support frame 2 is constructed of steel. Alternatively,main support frame 2 may be made of any suitable material capable ofsupport. Shaft 3 is coupled to linear bearings 8. Four springs 19provide the tension needed to keep the cams 31 and 33 against theirrespective cam followers (FIG. 3 and FIG. 5). When cam 31 rotates,spring 19 provides tension to keep cam follower 34 in close contact.When linkages 37 and 38 displace link 39, bracket 45 is displaced. Thedisplacement of bracket 45 along the z-axis causes a tilt of seat 12.The preferred embodiment for this invention is a closed track camsystem, negating the need for spring 19.

Depicted in FIG. 4 is a rear view of three dimensional mover 100according to the present disclosure. A motor 13 powers thehippotherapy/therapeutic riding device. In a most typical embodiment,motor 13 may be about 1.0 to about 5.0 horsepower, continuous-duty, DCmotor that can achieve about 1725 rotations per minute. It is recognizedthat these motor parameters are for illustrative purposes, and thatother rotations, powers, or gearing systems may be employed within thescope and spirit of the invention. Attached to motor 13 is a timing beltor chain 14. Timing belt or chain 14 is mounted upon a sprocket 15 thatis attached to motor 13. Timing belt or chain 14 is also mounted upon asprocket 16. Sprocket 16 is attached to a main shaft 7. Main shaft 7 issupported by ball bearings 17. An accordion-style rubber billows 71 overa thin metal plate covers the mechanical aspect of the machine from seat12 to base 1. The billows 71 allow flexibility of the device duringthree dimensional movement.

Mechanically coupled to main shaft 7 is at least one cam. Schematicallyillustrated in the present embodiment are six cams. The actual diameterand contour of the cam surface is not shown. Each cam may be customizedto meet the specifications described in FIG. 7 through FIG. 32. The camsare designed to drive the typical embodiment of the disclosedhippotherapy/therapeutic riding device in a three dimensional pattern.Specifically, the cams simulate the motion of the left and right legs ofa horse. Each cam pair (for the left and right side) is custom designedand positioned to simulate the motion along one of the three axes ofrotation. Since each axes of rotation provides distinctly differentdegrees and sequences of motion, the three cam sets are of differentdesigns. In addition, the cams within each pair are positioned at 180°of each other to simulate the left and right side of the horse.Furthermore, each cam set pertaining to one of three dimensions ofmovement can be customized in a wide range of shapes and sizes. Sincethe three cam sets operate independently on one another, the degree ofmotion along one or more axes of rotation can be manipulated withoutaltering the degree of motion provided along the other axes of rotation.It is recognized that one may desire to operate the three dimensionalmover with a single cam, a plurality of cams, drives, cam plates,linkages, microprocessors or other means to simulate various threedimensional movements and still practice the present invention.

Outer cam 33 b (on the left side) rotates along the x-axis. The camfollower 36 b is kept against the cam with the aid of tension providedby spring 19-33 b. The preferred embodiment for this invention utilizesa closed track cam system to keep the cam follower against the cam.Movement of linkage 53 b results in a rotation of the seat forward aboutthe local z-axis. There is a corresponding displacement of seat 12 inthe y-direction (FIG. 2 shows the coordinate system). Looking toward thelocal z-axis (down onto the seat), clockwise rotation of point B (on theleft) results in a negative y-displacement of point B. This results in aforward rotation of seat 12 b, but does not directly affect the positionof point A. It should be noted that clockwise rotation of point A alongthe local z-axis results in displacement of point A in a positivey-direction. The specifications of this movement are described in detailin FIG. 25 through FIG. 32.

Cam follower 35 a traces the rotation of inner cam 32 a to produce anupward and downward movement of seat 12 a. This displacement along thez-axis is achieved through rotation of the cam about the local x-axis.FIG. 16 through FIG. 24 provide the displacements and correspondingrotation of a typical embodiment. It is understood that the shape of thecam affects the amount of displacement. In a typical embodiment,displacement from neutral to about 0 cm to about 5 cm can be achievedwith varying sizes and shapes of the cam.

Innermost cam 31 rotates on the local x-axis. Spring 19 provides thetension to keep the cam follower 34 in close contact with the cam. Aclosed track cam system is the preferred embodiment for this invention,negating the need for spring 19. When linkages 37 and 38 displace link39, bracket 45 is displaced in a negative z-direction, causing seat 12to tilt upward (posterior tilt). This corresponds to a clockwiserotation of cam 31 on the left side at point B (looking toward thex-axis direction; i.e., left to right). FIG. 7 through FIG. 15 providethe specifications regarding the degree of rotation about the localx-axis at points A and B. It is understood that the degree of rotationabout the local x-axis can be altered through the shape or size of cam31, directly affecting the anterior (downward) or posterior (upward)tilt, i.e.; z-displacement of seat 12 and still be within the scope andspirit of this invention.

Outer cams 33 rotate against cam followers 36. In a most typicalembodiment, cams rotate on cam bearings constructed of steel ballbearings. Other suitable materials known in the art may alternatively beused for cam bearings. Inner cams 32 rotate against cam followers 35. Ina most typical embodiment, cams rotate on cam bearings constructed ofsteel ball bearings. Other suitable materials known in the art mayalternatively be used for cam followers 35.

As the action of the cams rotate seat 12 forward and backward in partialsimulation of a horse's movements, seat 12 is supported by the mechanismof frame 6. Linear bearings 8 are coupled to a linear bearing base plate4. Linear bearings 8 provide movement along the y-axis in response torotation of the outer cams. Linear bearing base plate 4 supports bearinghub 5 for rotation. Bearing hub 5 provides rotation on the z-axis and iscoupled to a subframe 6. Subframe 6 supports arms 11. Subframe 6 may bemade of any material suitable for support arms 11. In a most typicalembodiment, subframe 6 is constructed of about 2.54 cm (1 inch) solidround steel. Arms 11 may similarly be constructed from any suitablematerial, including, but not limited to plastic, wood, metal, titaniumor any alloy combinations. In a most typical embodiment, arms 11 aremade of aluminum. Arms 11 are attached to bushings on shaft 40. Shaft 40is attached to bearings 29. Bearings 29 attach to seat 12.

FIG. 5 is a top view of the three dimensional mover once the seat andupper linkages have been removed. The use of reference numerals in FIG.5 correspond to the same elements with the reference numerals set forthin FIGS. 3 and 4. While the use of springs to apply tension to the camfollowers is one method of maintaining pressure on the cam, thepreferred method may be the use of a closed track cam system, negatingthe need for springs. In addition, it is recognized that there areseveral methods known in the art to achieve three dimensional motion. Itis within the scope and spirit of this invention to utilize computergenerated programs or alternative methods that provide rotational forcesin three dimensions.

In FIG. 6, there is illustrated a hand held device 21. Hand held device21 includes safety switch 25 and a varistat 30. Switch 25 lets acaregiver quickly shut off the power to the three dimensional mover.Varistat 30 controls the simulated number of steps per minute of theriding device. As illustrated, varistat 30 allows a caregiver to adjustthe number of simulated steps per minute to be preferably between about60 and about 120 cycles per minute. Currently, this is believed to bethe ideal pace for therapeutic benefits to a rider. However, otherfrequencies are within the scope of the present disclosure. For example,in certain embodiments, the number of simulated steps is between about40 to about 200 horse steps per minute. It is envisioned that thevaristat could be in the range of 20 to 200 cycles per minute orSpecifically, varistat 30 may be adjusted to provide for any number ofsimulated steps per minute.

It is a feature of the present riding device that the six cam system(consisting of two outer, two inner, and two innermost cams) may becompletely customized to create any number of three dimensional movementpatterns of seat 12. By changing the size, shape, or other configurationof any or all of the cams, one may alter the movement of seat 12.Various degrees of movement in one, two, or three planes can be achievedby altering the cam(s) or utilizing other methods to provide rotationalforces and still be within the scope and spirit of this invention. Thefunction of the cams is to simulate all aspects of a horse's motion.Particularly, the triple cam system simulates aspects including, but notlimited to: deceleration of a horse's hind limb during swing, a horse'sstance when one hind limb is fully extended under its pelvis,alternating steps of a horse's hind limbs, the rotation of a horse'strunk, the shift of a horse's trunk, the tilt of a horse's pelvis in twoplanes, and push-off and swing-through of a horse's hind limbs duringgait.

It is a feature of the three dimensional mover that the cams may besubstituted for other cams having different eccentricities or other suchattributes. Depending upon how each cam is machined, such an exchangemay provide for an increase or decrease in the resulting y-axisdisplacement, x-axis displacement, or z-axis displacement. It is alsorecognized that the width of the three dimensional mover will affect theresults of rotation about the local z-axis. It is understood that theabove described shapes, widths, dimensions, sizes of the cams andmembers, and location of the axis of rotation of the disclosed devicecould be altered and still be within the scope and practice of the threedimensional mover. The patient's therapeutic benefit in relation tochanges in tilt, displacement, and rotation provided by the threedimensional mover will depend upon the size of the rider's pelvis, aswell as the rider's degree of joint motion, muscle tone, flexibility,and motor control.

FIG. 7 illustrates the rotation about the local x-axis at points A and Bcausing a displacement of the rider at points C and D, simulating theanterior or posterior tilt of the horse's pelvis.

FIG. 8 illustrates the degree of rotation about the local x-axispertaining to terminal stance of the horse's right hind limb and hoofstrike of the left hind limb.

FIG. 9 illustrates the degree of rotation about the local x-axispertaining to push-off of the horse's right hind limb and initial stanceof the left hind limb.

FIG. 10 illustrates the degree of rotation about the local x-axispertaining to mid-swing of the horse's right hind limb and mid-stance ofthe left hind limb.

FIG. 11 illustrates the degree of rotation about the local x-axispertaining to terminal swing of the horse's right hind limb and latestance of the left hind limb.

FIG. 12 illustrates the degree of rotation about the local x-axispertaining to hoof strike of the horse's right hind limb and terminalstance of the horse's left hind limb.

FIG. 13 illustrates the degree of rotation about the local x-axispertaining to initial stance of the horse's right hind limb and push-offof the horse's left hind limb.

FIG. 14 illustrates the degree of rotation about the local x-axispertaining to mid-stance of the horse's right hind limb and mid-swing ofthe hose's left hind limb.

FIG. 15 illustrates the degree of rotation about the local x-axispertaining to late stance of the horse's right hind limb and terminalswing of the horse's left hind limb.

FIG. 16 illustrates the z-displacements of points A and B along thez-axis as a result of rotation of cam 32 a or 32 b about the localx-axis

FIG. 17 illustrates the z-displacements of points A and B due torotation of the cams about the local x-axis pertaining to terminalstance of the horse's right hind limb and hoof strike of the left hindlimb.

FIG. 18 illustrates the z-displacements of points A and B due torotation of the cams about the local x-axis pertaining to push-off ofthe horse's right hind limb and initial stance of the left hind limb.

FIG. 19 illustrates the z-displacements of points A and B due torotation of the cams about the local x-axis pertaining to mid-swing ofthe horse's right hind limb and mid-stance of the left hind limb.

FIG. 20 illustrates the z-displacements of points A and B due torotation of the cams about the local x-axis pertaining to terminal swingof the horse's right hind limb and late stance of the left hind limb.

FIG. 21 illustrates the z-displacements of points A and B due torotation of the cams about the local x-axis pertaining to hoof strike ofthe horse's right hind limb and terminal stance of the horse's left hindlimb.

FIG. 22 illustrates the z-displacements of points A and B due torotation of the cams about the local x-axis pertaining to initial stanceof the horse's right hind limb and push-off of the horse's left hindlimb.

FIG. 23 illustrates the z-displacements of points A and B due torotation of the cams about the local x-axis pertaining to mid-stance ofthe horse's right hind limb and mid-swing of the hose's left hind limb.

FIG. 24 illustrates the z-displacements of points A and B due torotation of the cams about the local x-axis pertaining to late stance ofthe horse's right hind limb and terminal swing of the horse's left hindlimb.

FIG. 25 illustrates the degree of rotation about the local z-axis andthe implied displacement along the local y-axis pertaining to terminalstance of the horse's right hind limb and hoof strike of the left hindlimb. Not illustrated is the corresponding lateral displacement alongthe local x-axis as a function of the arc of rotation or the degree oflateral pelvic tilt.

FIG. 26 illustrates the degree of rotation about the local z-axis andthe implied displacement along the local y-axis pertaining to push-offof the horse's right hind limb and initial stance of the left hind limb.Not illustrated is the corresponding lateral displacement along thelocal x-axis as a function of the arc of rotation or the degree oflateral pelvic tilt.

FIG. 27 illustrates the degree of rotation about the local z-axis andthe implied displacement along the local y-axis pertaining to mid-swingof the horse's right hind limb and mid-stance of the left hind limb. Notillustrated is the corresponding lateral displacement along the localx-axis as a function of the arc of rotation or the degree of lateralpelvic tilt.

FIG. 28 illustrates the degree of rotation about the local z-axis andthe implied displacement along the local v-axis pertaining to terminalswing of the horse's right hind limb and late stance of the left hindlimb. Not illustrated is the corresponding lateral displacement alongthe local x-axis as a function of the arc of rotation or the degree oflateral pelvic tilt.

FIG. 29 illustrates the degree of rotation about the local z-axis andthe implied displacement along the local v-axis pertaining to hoofstrike of the horse's right hind limb and terminal stance of the horse'sleft hind limb. Not illustrated is the corresponding lateraldisplacement along the local x-axis as a function of the arc of rotationor the degree of lateral pelvic tilt.

FIG. 30 illustrates the degree of rotation about the local z-axis andthe implied displacement along the local y-axis pertaining to initialstance of the horse's right hind limb and push-off of the horse's lefthind limb. Not illustrated is the corresponding lateral displacementalong the local x-axis as a function of the arc of rotation or thedegree of lateral pelvic tilt.

FIG. 31 illustrates the degree of rotation about the local z-axis andthe implied displacement along the local y-axis pertaining to mid-stanceof the horse's right hind limb and mid-swing of the hose's left hindlimb. Not illustrated is the corresponding lateral displacement alongthe local x-axis as a function of the arc of rotation or the degree oflateral pelvic tilt.

FIG. 32 illustrates the degree of rotation about the local z-axis andthe implied displacement along the local y-axis pertaining to latestance of the horse's right hind limb and terminal swing of the horse'sleft hind limb. Not illustrated is the corresponding lateraldisplacement along the local x-axis as a function of the arc of rotationor the degree of lateral pelvic tilt.

FIG. 33 through FIG. 35 schematically illustrate the three dimensionalmover as a cylinder; however the actual design is depicted in FIG. 3through FIG. 5. FIG. 34 and FIG. 35 indicate use of the threedimensional mover for encouragement of developmental sequences oralternatively for training in vaulting techniques. FIG. 35e illustratesthe use of the three dimensional mover to provide continuous passiverange of motion to the wrists or shoulders. Similarly, the ankle couldreceive three dimensional passive range of motion if the patient isseated on a stationary platform twice as high as the three dimensionalmover in such a way that the patient's foot dangles down to weightbearon the device. Alternatively, the patient could experience passive rangeof motion to the hips and low back by assuming the hands and kneesposition (FIG. 34b) with the upper extremities weightbearing on astationary surface (not illustrated).

It will be appreciated that the therapeutic riding device describedabove may be used for research of the effectiveness of simulatedhippotherapy. Research using the three dimensional mover may be tailoredso that only certain parameters are varied. For example, the cam designof the therapeutic device allows researchers to easily change one ormore specific aspects of simulated horse motion. Those changes mayperhaps then be correlated with physical or behavioral changes ofriders.

It will further be appreciated that the hippotherapy simulator describedabove may be equipped with a saddle and/or stirrups. Utilizing a warmingunit on or within surface 70 may simulate bareback riding. The ridingdevice may also be equipped with an overhead support frame. The supportframe would be sturdy enough to support a harness for three pointpartial suspension of the rider. A trunk and pelvis jacket, available indifferent lengths depending on the need for support could provide theamount of support. The trunk and pelvis jacket would be made of canvas,porous mesh plastic, cloth or other suitable material. The therapistcould determine the percent of gravity eliminated through the use ofsuspension and could be controlled using the tension supplied throughsupport cables leading from the trunk jacket to the overhead supportframe. The three dimensional mover may also be equipped with platformsto support various additional equipment, such as ventilator, oxygentank, intravenous poles, electrocardiogram monitor, electromyographycomputer, pulse oximeter, oxygen cart for collection of expired air, orany other medical equipment which may serve useful to the rider orresearcher. Alternatively, such equipment could be separate from theriding device, but within a distance for comfortable and safe connectionto the patient with hoses, lines, leads, wires, tubes, and/or cables.

Finally, it will be appreciated that in constructing a hippotherapyapparatus according to the present disclosure, certain significantadvantages are provided. In particular, the disclosed three dimensionalmover allows impaired patients to undergo controlled, ideal hippotherapyin a safe, comfortable setting.

The foregoing description has been directed to a particular embodimentin accordance with the requirements of the Patent Statutes for thepurposes of illustration and explanation. It will be apparent, however,to those skilled in the art that many modifications and changes in theapparatus set forth will be possible without departing from the scopeand spirit of the invention. It is intended that the following claims beinterpreted to embrace all such modifications and changes.

What is claimed is:
 1. An apparatus for performing hippotherapy, saidapparatus comprising: a seat configured to support a rider; at least oneouter cam coupled to said seat and configured to propel said seat in afirst set of directions; at least one inner cam coupled to said seat andconfigured to propel said seat in a second set of directions; at leastone innermost cam coupled to said seat and configured to propel saidseat in a third set of directions; and a motor coupled to said at leastone outer cam and said at least one inner cam and said at least oneinnermost cam to drive said at least one outer cam and said at least oneinner cam and said at least one innermost cam.
 2. The apparatus of claim1, wherein said at least one outer cam is machined differently from saidat least one inner cam to create an alternating movement pattern of saidseat corresponding to an alternating pattern of a horse's gait.
 3. Theapparatus of claim 1, wherein said at least one outer, inner, orinnermost cam is substituted with another outer, inner, or innermost camhaving different attributes to cause a change in a movement pattern ofsaid seat.
 4. The apparatus of claim 1, wherein said first set ofdirections is generally orthogonal to said second set of directions andto said third set of directions.
 5. The apparatus of claim 1, where acombination of said first, second and third set of directions producessimulated three dimensional motion of a horse.
 6. The apparatus of claim5, wherein said simulated three dimensional motion comprises about 60 toabout 120 simulated horse steps per minute.
 7. The apparatus of claim 5,wherein said simulated three dimensional motion causes said rider toexperience a cyclic lateral pelvic tilt of approximately 5 to 15degrees.
 8. The apparatus of claim 5, wherein said simulated threedimensional motion causes said rider to experience a cyclic lateralpelvic displacement of approximately 3 centimeters to about 12centimeters.
 9. The apparatus of claim 5, wherein said simulated threedimensional motion causes said rider to experience a cyclic anterior orposterior tilt of about 3 degrees to about 10 degrees.
 10. The apparatusof claim 5, wherein said simulated three dimensional motion causes saidrider to experience a cyclic pelvic rotation of about 3 degrees to about15 degrees.
 11. An apparatus for hippotherapy, comprising: a seatconfigured to support a rider; a support frame coupled to said seat,said support frame for housing mechanical components for movement ofsaid seat; said mechanical components comprising: a first pair of camscoupled to said seat for movement of said seat along a first axis, saidfirst pair of cams being spaced apart by a first distance; a second pairof cams coupled to said seat for movement of said seat along a secondaxis, said second pair of cams being spaced apart by a second distance,said second distance being greater than said first distance; a thirdpair of cams coupled to said seat for movement of said seat along athird axis, said third pair of cams being spaced apart by a thirddistance, said third distance being greater than said second distance;said first, second, and third pairs of cams for moving said seat inthree dimensions; and a motor operatively coupled to provide motivepower to said first, second, and third pairs of cams.
 12. The apparatusof claim 11, wherein said apparatus simulates three dimensional movementof a horse without associated simulated legs of said horse.
 13. Theapparatus of claim 11, further comprising a tilt mechanism coupled tosaid support frame for inclining said seat.
 14. The apparatus of claim11, further comprising a safety switch to stop operation of saidapparatus.
 15. The apparatus of claim 11, further comprising a timingbelt coupled to said motor, said timing belt adapted to providerotatable movement to a shaft, said shaft mechanically coupled to saidfirst, second, and third pairs of cams.
 16. The apparatus of claim 15,further comprising a pair of cam followers, each one of said pair of camfollowers being adjacent one of said first pair of cams, each of saidpair of cam followers being tensioned by a spring, said spring beingcoupled to a linkage, said linkage being coupled to said seat.
 17. Theapparatus of claim 11, wherein each of said first, second, and thirdpairs of cams comprise different eccentricities.
 18. The apparatus ofclaim 11, wherein said seat comprises a first and second surface, saidfirst and second surfaces permitting independent three dimensionalmovement of a first portion and a second portion of said seat.
 19. Theapparatus of claim 18, further comprising an exchangeable platform foraccommodating said rider on said seat.
 20. The apparatus of claim 19wherein said exchangeable platform comprises a heated surface.
 21. Amethod for performing hippotherapy without use of a horse, comprising:providing an apparatus capable of three dimensional movement, saidapparatus having a seat configured to support a patient; a support framecoupled to said seat, said support frame including mechanical componentsfor movement of said seat; said mechanical components comprising amotor, a plurality of cams coupled to said seat to provide said threedimensional movement; positioning said patient on said seat; andapplying operating power to said motor to drive said seat in said threedimensional movement, thereby providing said hippotherapy to saidpatient without use of said horse.
 22. The method of claim 21, furthercomprising activating a safety switch to stop operation of saidapparatus.
 23. The method of claim 21, wherein said seat comprises afirst and second surface, said first and second surfaces permittingindependent three dimensional movement of a first portion and a secondportion of said seat.
 24. The method of claim 21, further comprisingpositioning a therapist on said seat and behind said patient.
 25. Themethod of claim 21, wherein said three dimensional movement comprisesabout 60 to about 120 simulated horse steps per minute.
 26. The methodof claim 21, wherein said three dimensional movement causes said patientto experience a cyclic lateral pelvic tilt of approximately 5 to 15degrees.
 27. The method of claim 21, wherein said three dimensionalmovement causes said patient to experience a cyclic lateral pelvicdisplacement of approximately 3 centimeters to about 12 centimeters. 28.The method of claim 21, wherein said three dimensional movement causessaid patient to experience a cyclic anterior or posterior tilt of about3 degrees to about 10 degrees.
 29. The method of claim 21, wherein saidthree dimensional movement causes said patient to experience a cyclicpelvic rotation of about 3 degrees to about 15 degrees.
 30. The methodof claim 21, wherein said cams further comprise a first pair of camscoupled to said seat for movement of said seat along a first axis, saidfirst pair of cams being spaced apart by a first distance; a second pairof cams coupled to said seat for movement of said seat along a secondaxis, said second pair of cams being spaced apart by a second distance,said second distance being greater than said first distance; a thirdpair of cams coupled to said seat for movement of said seat along athird axis, said third pair of cams being spaced apart by a thirddistance, said third distance being greater than said second distance;said motor being operatively coupled to said first, second, and thirdpair of cams.